Doganay Sir Astley Paston Cooper 209

Journal of Medical Biography 23(4) 209–216 ! The Author(s) 2015 Sir Astley Paston Cooper (1768–1841): Reprints and permissions: sagepub.co.uk/journalsPermissions.nav The man and his personality DOI: 10.1177/0967772013506683 jmb.sagepub.com

Emre Doganay

Abstract The most acclaimed surgeon of his time, Astley Cooper, a man from Norfolk and a student of the eminent John Hunter, was an outstandingly successful surgeon. With his accomplishments in surgery and experiments in dissection he soon became a prominent figure and received recognition worldwide. At the young age of 21 he was appointed Demonstrator in Anatomy at St Thomas’s Hospital in London and two years later was made Joint Lecturer in Anatomy and Surgery. With his passion for anatomy, his love for surgery and his expanding knowledge he became Surgeon to Guy’s Hospital in 1800 and in the same year was elected a Fellow to the Royal Society. His attainments led him to become surgeon to three successive British monarchs as well as receiving a bestowal of Baronetcy. Through his edifying lectures, fastidious experiments and publications on anatomy and pathology he has inspired and enlightened many budding anatomists and surgeons and the principles of his teachings still prevail in practice today.

Keywords Astley Cooper, John Hunter, William Cooper, Isaac Newton, Brooke Hall, Henry Cline, Benjamin Travers, Copley Medal, Benjamin Brodie, Serjeant Surgeon

The English county of Norfolk to go to University and instead he received domestic education from his parents and in the meantime was Astley Cooper was born on 23 August 1768 at Brooke in sanctioned to run wild and adopt a devious boyhood, Norfolk. His father Reverend Samuel Cooper (1740– finding himself in all sorts of escapades.1 1800) was a country clergyman and his mother, Maria Astley Cooper’s interest in surgery may have Susanna Bransby (1737–1807), a descendant of Sir Isaac stemmed from a memorable incident in his youth Newton, was a successful authoress. Of Astley Coopers’ where, under immense pressure, he demonstrated an nine siblings, five of the girls died of tuberculosis as did act of boldness and ceased a haemorrhage: one boy, Samuel Lovick (1763–1817), who was father of Bransby Cooper (1792–1853).1 A foster brother of mine, named John Love, aged The family was wealthy. Astley spent much of his about 13 years was playing and fell as a wagon was youth in the opulent Brooke Hall. During the early passing, and one of the wheels of the wagon went years of his life he was sent to live with a wet nurse, Mrs over the back of the knee, as he lay with his face to Love, an unconventional decision taken by his mother. the ground. The wagon stopped and when he was He spent five years on the Love’s farm and later referred drawn from under it, a stream of blood directly burst to them as his adopted family. In the later years of his life, from his ham; a handkerchief was tied tightly over the while writing a treatise on the breast, he heavily criticised wound, and was carried home in a fainting state.3 being wet-nursed: ‘All animals, even those of the most ferocious character, show affection for their young – do At the expense of his foster brother, Cooper began his not forsake them, but yield them their milk, – do not academic journey and went on to gain experience in neglect, but nurse and watch over them’.2 apothecary. He soon became apprenticed to Edward Raised in a propitious environment where both his parents flourished in prosperous careers and his broth- Somers Cancer Research Building, Southampton General Hospital, ers obtained degrees at Cambridge, Cooper’s paternal Southampton, UK grandfather was a surgeon at Norwich and his uncle Corresponding author: William Cooper was senior surgeon to Guy’s Emre Doganay, Somers Cancer Research Building, MP824, Southampton Hospital. Under these favourable conditions he was General Hospital, Southampton, SO16 6YD, UK. reputed to be a poor scholar who lacked aspirations Email: [email protected] 210 Journal of Medical Biography 23(4)

Digby, a local Surgeon at the Norfolk and Norwich and in 1789 at the age of 21 was appointed demonstra- Hospital. His interest in surgery was kindled during tor in anatomy at St Thomas’s. He continued with his this time when he watched Mr Donnee operate on a studies and became more absorbed in his private experi- bladder calculus. ments on stray animals. He was becoming a distin- Cooper decided to embark in Surgery as a career and guished figure and with his willingness to teach he moved to London in August 1784. He was articled to proved to be a remarkable demonstrator. his uncle William Cooper, Senior Surgeon to Guy’s Furthermore, he gained much popularity as a member Hospital.4 of the Physical Society where he spoke with courage and fortitude at meetings.6 New beginning In 1791, Cooper was appointed lecturer in anatomy as an assistant to Mr. Cline. Still a student and a novice Up until 1825, Guy’s and St Thomas’s were referred to in surgery, Cline saw it suitable to do business with as the United Hospitals, closely affiliated with each Cooper largely because of his aspiring personality and other and students of each institution attended teaching thirst for teaching. It was at this time largely as a result in both hospitals. Lectures in medicine were given at of Cooper’s suggestions that the traditional teaching of Guy’s and combined lectures in anatomy and surgery at anatomy and surgery were separated. He believed there St Thomas’s. was more to Surgery than anatomy and that pathology, Cooper demonstrated quite a somnolent attitude embryology and physiology all had to be integrated. towards his studies; failing to impress in his first This was a radical change to be instituted by such a year, his uncle had no inclination to provide for young man.6 him. This left Cooper in a predicament and he In 1791 Cooper married Ann Cock, the daughter of switched allegiance to Mr Henry Cline (1750–1827), a wealthy merchant who left Cooper a fortune of Surgeon to St Thomas’s, a colleague of William ƒ14,000 and bought a house for them in Jefferies Cooper and student of John Hunter (1728–1793). Square. In the summer of 1792 the couple travelled to Cline, unlike William Cooper, was patient with his Paris, a City that greeted them with heightening polit- student and one day challenged Cooper to dissect an ical uneasiness. The purpose of Cooper’s visit was to arm. To his amazement, with skill and precision study the work and teachings of the great French sur- Cooper managed to complete the task. This episode geons for which he attended the lectures and operations may have transformed his indolent attitude, marking of Dessault and Chopart (1743–1795).3 the beginning of his career. Indeed, Cline imposed much influence on Cooper; the solidarity which arose Surgeon between the two men was thought to be an encoura- ging factor in establishing the firm foundations of With seven years of hard work behind him, at the age what Cooper was to become. Eager to study cadavers of 23 Astley Cooper stood before a long career of and accompany Cline on ward rounds, slowly his achievements. He devoted himself wholly to his work knowledge began to sprout as he grew confident in and desired to sharpen and enhance his training. He the field of anatomy and surgery.5 was determined not to seek private practice and offered Astley Cooper attended a series of lectures given by his time to see non-paying patients. In his own words John Hunter whose character and wisdom had imme- diate impact on him. Hunter’s lectures on aneurysms For three years after my apprenticeship expired, I did and his experimental work engaged Cooper’s attention not seek business, but devoted myself to the study of and inspired him to conduct animal experiments of his my profession, and to teaching the students entirely. own. He would ligate femoral arteries and observe the My industry at this time may be gathered from the animals heal and later kill them to demonstrate collat- following circumstances.3 eral circulation. Cooper soon became engrossed in animal experiments that he would conduct on the The first course of lectures he gave on surgery was dis- blood vessels of dogs and cats. appointing. His teachings were unsuitable for students and this was reflected in the poor attendance of students Professional development at his second course of lectures. Cooper resolved this by adopting a distinct fashion of teaching, one that was less In October 1787, at the start of his fourth year, Cooper vivid and far less abstract and designed to attract and visited Edinburgh where he studied under Professor retain the attention of the students. He introduced cases Alexander Monro Secundus (1733–1817), son of from the hospital wards and selected patients suffering Aleander Monro Primus (1697–1767). After seven from a disease that had a bearing on the subject of his months in Edinburgh, Cooper returned to London lecture. By the winter season of 1793 Cooper had Doganay Sir Astley Paston Cooper 211 become a reputed lecturer and this was reflected by the Furthermore, Cooper’s private practice was growing overwhelming attendance of his students.1 and with his new position at Guy’s he was earning ƒ1000 At the age of 25 he was merited as Professor of a year. He was absorbed in his work and did not com- Anatomy at Surgeon’s Hall. This position entailed per- promise his constant experimental dissections. His loft forming public dissections of the bodies of criminals exe- occupied up to 30 dogs at one time as well as cats, snakes cuted at the Old Bailey. Cooper held this position for two and rabbits ready to be sliced, injected, dissected and years and preferred not to continue for a third year.6 preserved. Cooper performed his experiments purely The Winter of 1794 witnessed the death of the out of curiosity and in one particular experiment he Cooper’s first child, Anna Maria. Grief-stricken, they chose to destroy the blood supply to one of his dog’s adopted a baby girl, Sarah, who was brought up as testicles and then cut the vas deferens on the other their own. Cooper threw himself wholeheartedly into side. Later, when he killed the animal, the testicle his work and remained engaged in his lectures, clinical where the blood supply had been ligated had shrunk teaching and research. He became a fervent attendant while that on the other side was large and healthy. By at the Physical Society and in 1798 a volume called slicing the vas deferens he failed to find damage to the Medical Records and Researches was published, testicle and the two ends of the vas did not join up again. comprising selected essays based on papers read at its This is the scientific basis of vasectomies performed in meetings. These records contained two of Cooper’s practice today but whether it was inspired by Astley essays, one a report of a case of diaphragmatic hernia Cooper remains a mystery.5,7 and the other a report on the observation and experi- ments on obstruction of the thoracic duct. The two Professional attainments reports were his first surgical publications.1 Four years later, in 1797 the Coopers moved to 12 St In 1800 Cooper read to the Royal Society a paper Mary Axe, the former house of Henry Cline. Cooper entitled Observations on the effects which take place did this for two reasons: ‘It is well calculated to private from the destruction of the membrane tympani of the practice, and has also a large warehouse attached to it, ear8 and in the following year he read a second paper which will make a most admirable dissecting room’.3 in which he suggested myringotomy for obstructive Although his private practice was modest, it was deafness. His work was original and experimental and definitely fruitful since his income rose to ƒ610 a year. earned Cooper the honour of becoming a Fellow of the In addition, he did not abstain from seeing poor non- Royal Society and receiving the prestigious Copley paying patients. The large warehouse indeed proved to Medal, the highest honour the Society could bestow8 be an admirable dissecting room, permitting Cooper to (Figure 1). exercise his skills and dissection. He was not reserved about his work and accepted unusual animals to dis- Treatise on hernia in 1804 sect, for example an elephant which he received from the Royal Menagerie.5 The year 1804 saw the publication of the first volume of Treatise on Hernia,9 one of his greatest works, centred Surgeon to Guy’s Hospital upon inguinal hernia. The second volume that followed in 1807 was concerned with femoral, umbilical, obtur- In 1800 William Cooper was due to retire from Guy’s ator, sciatic, diaphragmatic and mesenteric herniae.10 after fulfilling a laborious career. Of the four candi- Moreover, Cooper was the first to give an accurate dates, Astley Cooper was the leading surgeon to fill description of the internal abdominal ring and the the vacancy and Cooper was most impressive with his fascia transversalis. He is also commemorated by the professional attainments and after presenting his appli- attachment of his name to what he himself depicted as cation to the Board of Governors Astley was chosen to the ligament of pubis (Astley Cooper’s Ligament). His succeed his uncle and joined Guy’s as Surgeon in explanation of the surgery of strangulated hernia, October.1 where he carefully delineates it, is captivating and pro- Patients were regarded as fortunate to receive his ser- vides an account of two personal experiments to sup- vices and students lucky to have him as their mentor due port this. to his knowledge and acclaimed teaching abilities. Benjamin Travers (1753–1858) who was apprenticed to Work on aneurysms Astley Cooper describes his work at this time: ‘Guy’s Hospital, to which he was newly elected surgeon, Cooper, like John Hunter, was fascinated by the dis- shared a large portion of his time. His interest in his tinct behaviour of arteries and the body’s capacity to profession was genuine, independent of the additional develop collateral circulation. As a medical student, incitement of the love of reputation or of gain’.3 Cooper performed a series of investigations on the 212 Journal of Medical Biography 23(4)

Figure 1. Sir Thomas Lawrence’s portrait of Astley Cooper. Royal College of Surgeons England.

Figure 2. Illustrations of the neck, chest and heart of a dog cerebral circulation in dogs and showed that both car- dissected by Astley Cooper. The Gordon Museum, Guy’s otid arteries could be ligated without harm to the dog. Hospital. He demonstrated that the vertebral arteries prevent hypoxia of the cerebrum but that ligation of both vertebrals was usually fatal. One dog was fortunate Three years later, on 22 June 1808, came Cooper’s to survive and lived for nine months after ligation second opportunity. Humphrey Humphries, fifty years of both the carotids and vertebrals, before being of age, presented with an aneurism about the size of a killed to demonstrate the collateral circulation that walnut on the left side of his neck. The carotid artery developed11(Figure 2). was tied and divided between the ligatures; the patient’s Diseases of the carotids, including aneurysms, were recovery was unremarkable and he survived for four- deemed untreatable until Cooper met Mary Edwards teen years and died from cerebral haemorrhage. On the on 1 November 1805. He took particular interest in same afternoon of 22 June 1808 Cooper ligated the her case and performed the first common carotid external iliac artery for a femoral aneurysm. His artery ligation to repair her aneurysm. A two-inch inci- patient, 39 years of age, recovered well and died sion was made along the sternomastoid, the common 18 years later.11,13 carotid was exposed, the vagus separated and two In 1817 came Cooper’s pinnacle achievement in thread ligatures were passed around the vessel and arterial surgery; ligation of the abdominal aorta, the tied firmly. All pulsation ceased and progress was most impressive and phenomenal operation of his good but on 21 November 1805 Mary Edwards died career. Charles Hutson, aged 39, was admitted to and autopsy revealed ‘inflammation of aneurismal sac’. Guy’s on 9 April 1817 for an aneurysm in the left Nonetheless, his ligation of the carotid artery was a groin. On the third day the swelling above Poupart’s bold surgical operation and one based on his numerous ligament increased from three to four inches, carrying animal experiments and observations.1,11,12 the peritoneum far from the lower part of the abdomen Doganay Sir Astley Paston Cooper 213 and reaching the common iliac artery. Ligation of the aorta was indicated: before Cooper operated he studied its surgical anatomy carefully and rehearsed a transper- itoneal exposure. With the confidence of success in his dog experiments, where he ligated the abdominal aorta and observed sufficient collateral channels to maintain the blood supply to the lower limb, he performed the surgery. The operation went well; a thread was passed successfully around the aorta about three-quarters of an inch above its bifurcation. Although the right limb recovered its warmth and sensation, the left limb, on the side of the aneurysm, became progressively pale and cold and the patient died forty hours after the operation. In hindsight, Cooper knew he neglected the operation until it was too late and that gangrene of the affected limb was inevitable. However, the fact that the opposite leg remained viable inspired hope in Cooper that survival could follow aortic ligation1,11,14 (Figures 3 and 4).

Daily work In 1806, Cooper moved to Broad Street. The years he spent at Broad Street were his most successful and indus- trious years. Cooper began his day at six in the morning. He would visit his private dissecting suite and work there until half-past seven. Satisfied with his morning efforts he dressed for the day and saw non-paying patients. A hasty breakfast followed since by now his private, wealthy patients were arriving and he would attend to them in his consulting room until one o’clock. At this time his carriage would take him to Guy’s where a large crowd of medical students greeted him. Cooper would waltz up the ward staircases causing mayhem as pupils Figure 3. Astley Cooper’s successful ligation of the aorta in a would push and tumble so as to get near to him and dog. The specimen is injected to show collateral circulation. The secure a front place during ward rounds. He would Gordon Museum, Guy’s Hospital pass from bed to bed inspecting his patients and as two o’clock drew closer pupils would leave the wards and go before midnight. He began dissecting furiously and across to St Thomas’s Hospital in anticipation of sought to procure animals of all types, foreign and Cooper’s lecture. After an hour of lecturing, generally domestic. The popularity of his lectures was reflected he would visit the dissecting room to comment on dis- in the consistent attendance of over 300 people sections and at half-past three would leave Guy’s to although this was to be relatively short lived. In 1814, attend to his private operations. He was occupied till with the death of his adopted daughter and the hard- six or seven in the evening and when he arrived home ship that came with the great labours of his practice, he he would engage in conversation until dinner was ready. decided to abandon his lectures.5,6 If it were the evening for his surgical lectures, he would Cooper’s health began to show signs of giving way. get into his carriage and drive to the hospital. If it were The immense labour that went into preparing his lec- not a lecture night, he would sit and talk to the family tures on comparative anatomy, his private practice and and to his apprentices about their daily work.3 his hospital work had threatened his wellbeing. On one In May 1813 the Council of the Royal College of particular occasion, when the Duke of Manchester Surgeons appointed Cooper Hunterian Professor in summoned him for a consultation, he was seized by Comparative Anatomy. The post entailed delivering a an attack of vertigo. He realised he must do less and course of 12 lectures. He began preparing his lectures in 1815 decided to leave his City practice and move to and his specimens, limiting his sleep to three or four New Street in the West End in the hope of restoring his hours a night and seldom reaching home from hospital health.3,5 214 Journal of Medical Biography 23(4)

This book contained an invaluable account of his oper- ation of ligation of the abdominal aorta for a leaking ilio-femoral aneurysm. Two years later he was appointed to the Court of Examiners at the College of Surgeons and later that year was summoned to remove an infected sebaceous cyst from the head of King George IV (1762–1830) who made Cooper a Baronet for his valour and aptitude, despite the risk of erysipelas. For his service he was also rewarded with a costly epergne, a table centrepiece designed by the King himself. He continued to attend to the King from there on and in 1828 was appointed Sergeant- Surgeon, a post he held for two years. Astley Cooper also served as Sergeant-Surgeon to William IV (1765–1837) and Queen Victoria (1819–1901) and later was given the honour of embalming the body of William IV.1,4

Treatise on fractures and dislocations In 1822 Cooper completed a monograph on Fractures and Dislocations and this treatise, though not based on as much original work as the Treatise on Hernia, was probably the most practical of his books and had the widest appeal. The monograph includes much of his original research and here almost all the common frac- tures and dislocations are shown dissected and displayed.16 Figure 4. Specimen from Astley Cooper’s case of ligation of the aorta in man. The Gordon Museum, Guy’s Hospital. Avoidance of amputation for compound fractures Sir Astley Cooper was indubitably the most success- ful Surgeon in London at the time and as a consequence The norm for treating compound fractures was often wealthy merchants paid very large fees for his services. immediate amputation of the limb but Cooper recom- His consultations rarely cost less than five guineas and mended this was not always necessary. In his opinion he was paid generously for long-distance visits. In the year 1815, when at the summit of his career, he was If loose fragments of bone can be felt, the wound earning the huge sum of ƒ21,000 a year.5 Cooper prac- should be enlarged for their removal and instead of tised Surgery not for gluttony but for the love of it and fomentations and poultices, a piece of lint, dipped in his perseverance, ability and knowledge brought him the patient’s own blood, be applied to the wound and remarkable success. Sir Benjamin Brodie (1783–1862), bound in place. The whole limb should then be immo- one of his earliest apprentices and Surgeon to St bilised on a splint. In the instance of suppurative pro- Thomas’s, said cess, a small opening should be made in the bandage to allow the escape of pus.16 Although he received from his practice a larger income than was ever obtained, either in the medical profession or in any other, he never exhibited anything approach- Astley Cooper’s method of reduction ing the vice of avarice. He was in the greatest degree of dislocated shoulder liberal.1,3 Astley Cooper’s concise description on how to use the Heel-in-the-axilla method of reduction for a dislocated Achievements shoulder was original. In this procedure the arm is placed in an abducted position while direct pressure is The year 1818 saw the first volume of Surgical Essays15 applied on the head of the humerus with the sole of the written in conjunction with Benjamin Travers. foot.16 Doganay Sir Astley Paston Cooper 215

Intracapsular fracture of the neck to practise once again. He regarded his short-lived retire- of the femur ment as an opportunity to write further monographs and in 1829 published Illustrations of the Diseases of the Astley Cooper performed copious investigations and Breast17 and in 1830 Observations on the Structure and experiments to understand the factors responsible for Diseases of the Testis18 a monograph also ranked the non-union that follows an intracapsular fracture of among his best works. the neck of the femur. By observation and dissection in In 1832 came an unexpected contribution, The man and by many experiments on animals, he concluded Anatomy of the Thymus Gland19 and in 1840 was his that in first circumstance non-union was the result of last publication The Anatomy of the Breast.2 This faulty apposition of fragments due to their separation monograph includes an account of the normal anatomy by muscular pull. Furthermore, a larger contributing of the breast, a short section on comparative anatomy factor is the imperfect blood supply to the proximal frag- and notes on the physiology of lactation. His most ment, purely as a result of the fracture. The importance exceptional contribution to the anatomy of the breast of such factors remains unchallenged today.16 is his description of the Ligamenta Suspensoria, known more commonly as Cooper’s Ligament of the Breast.2 Amputation at the hip joint in 1824 The final chapter On 15 January 1824 Cooper performed an amputation through the hip joint on a soldier from the Battle of In 1827, when Cooper returned to London his leader- Waterloo, an event that ignited vast interest throughout ship and domination of English Surgery was acknowl- Great Britain. Before the introduction of antiseptics edged by his election as President of the Royal College and anaesthesia, with courage and boldness Astley of Surgeons. Three years later he received another great Cooper successfully performed the operation and his honour when elected as one of the Vice-Presidents of patient made a good recovery although retarded by the Royal Society and, in 1836 was elected President of infection and suppuration in the stump.8,11 the College for the second time. In addition, he had honours from almost every country where medicine The retired teacher and surgery were practised. This included his election to the National Institute of France, his election as an Winter of 1824 was troublesome for Astley Cooper as Honorary Fellow to the Scottish Royal College of his sudden giddiness began to become increasingly fre- Surgeons and a Doctorate awarded by the University quent and disabling. By January of 1825, at the age of of Oxford. Moreover, he became a Fellow of the fifty-six and with increasing poor health, Cooper retired Royal Society of Gottingen and the Russian Imperial from hospital work as a full-time Surgeon. With his res- University of Vilna awarded him a Diploma. He was ignation accepted, Cooper now had the right to nomin- made a Corresponding Member of the First Class ate his successors and chose two men, his old student of the Royal Institute of the Netherlands, a member of John South and his nephew Bransby Cooper. However, the Society of Natural Philosophy of Heidelberg, of these were rejected by the Governors and John South the Physico-Medico Society of New Orleans, of the was appointed Lecturer in both Anatomy and Surgery. Academy of Medical Sciences of Palermo and of the Angered by this rebuttal, with the help of Benjamin Mexican Medical Society of Guadalajara.5,6 Travers Astley managed to persuade Guy’s to split By 1835 Cooper had reached the age of 67 and his from St Thomas’s and found an entirely separate med- health was failing. Until his last breath he was deter- ical school and thereby, splitting Guy’s and St Thomas’s, mined to do what he loved most. He continued to see Cooper created a new post for his nephew.1,5,6 patients and began preparing a book on Malignant Cooper was not inactive during retirement. Soon after Diseases of the Breast that unfortunately was never to the separation of the schools he was appointed be finished. At the end of 1840 he began to have grave Consulting Surgeon. Rather than withdrawing himself difficulty in breathing and in December of that year he from 30 years of practice, he used his retirement to seek retired to an armchair. His decline became progressive new knowledge. He was occupied in his private practice, from there on and on 12 February 1841, at the age of now busier than before, but the year 1827 proved to be 72, Sir Astley Cooper died. He was buried under the bitter as he witnessed the deaths of his great Master Cline Chapel at Guy’s Hospital. and his beloved wife, Lady Cooper. Such events exacer- bated Cooper’s already ill health and on the impulse of Acknowledgements his miserable state he retired from his practice altogether. I am indebted to William Edwards, Curator of The Gordon Cooper appreciated his freedom from practice but in six Museum at Guy’s, King’s and St Thomas’s Hospital Medical months, complaining of boredom, he returned to London School, London, for providing me with imperative 216 Journal of Medical Biography 23(4) information. I also express gratification to the librarians at 8. Cooper A. Observations on the effects which take place the Royal College of Surgeons of England for their assistance from the destruction of the membrana tympani of the ear. and to Sarah Pearson, Curator of the Hunterian Museum and London: W Blumer and Co, 1800. Louise King, Assistant Archivist at the College. I would like 9. Cooper A. The anatomy and surgical treatment of inguinal to thank Professor Harold Ellis personally for giving me this and congenital hernia. London, 1804. opportunity and for his continuous support. 10. Cooper A. The anatomy and surgical treatment of crural and umbilical hernia. London, 1807. 11. Ellis H. Operations that made history. Cambridge University Press, 2009, pp.17–26. References 12. Cooper A. A case of aneurism of the carotid artery. 1. Brock RC. The life and work of Astley Cooper. Medico-Chirurgical Transactions 1809; 1: 1–12. Edinburgh: ES Livingstone, 1952. 13. Cooper A. A second case of carotid aneurism. Medico- 2. Cooper A. On the Anatomy of the Breast. London: Chirurgical Transactions 1809; 1: 224–225. Longman, Orme, Green, Brown & Longman, 1840. 14. Ellis H. The Cambridge illustrated history of surgery. 3. Cooper B. Life of Sir Astley Cooper. London, 1843. Cambridge University Press, 2009, pp.67–70. 4. Jones R. Thomas Wakley, Astley Cooper, and the Death 15. Cooper A and Travers B. Surgical essays. London, of George IV. Journal of the Royal Society of Medicine pp.1818–1819. 2007; 7: 100. 16. Cooper A. A treatise on dislocations and on fractures of 5. Burch D. Digging up the dead. London: Chatto & the joints. London: Longman, Hurst, Rees, Orme and Windus, 2007. Brown, Paternoston Row, 1822. 6. Davis ED and Kinmonth. Catalogue of Sir Astley 17. Cooper A. Illustrations of the diseases of the breast. Cooper’s collection, Department of Surgery, St London: Longman, Rees, Orme, Brown and Green, 1829. Thomas’s Hospital Medical School, 1964. 18. Cooper A. Observations on the structure and diseases of 7. Cooper A. Lectures on the principle and practice of sur- the testis. London: Longman, 1830. gery with additional notes and cases by Frederick Tyrell. 19. Cooper A. The anatomy of the thymus gland. London: Vol. 2, London: Thomas and George Underwood, 1824. Longman, Reese, Orme, Green, and Brown, 1832.

Author biography Emre Doganay, BSc, is a final year medical student at Southampton University.

Journal of Medical Biography 23(4) 216–224 ! The Author(s) 2015 Sir John Struthers (1823–1899), Professor Reprints and permissions: sagepub.co.uk/journalsPermissions.nav of Anatomy in the University of Aberdeen DOI: 10.1177/0967772013506808 (1863–1889), President of the Royal jmb.sagepub.com College of Surgeons of Edinburgh (1895–1897)

MH Kaufman

Abstract Between 1841 and 1845 John Struthers attended both the University of Edinburgh and some of the various Extra-mural Schools of Medicine associated with Surgeons’ Hall. While a medical student he became a Member of the Hunterian

5 Moston Terrace, Edinburgh EH9 2DE, UK

Corresponding author: MH Kaufman, 5 Moston Terrace, Edinburgh EH9 2DE, UK. Email: [email protected]